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DRAFT FOR EHCT MEMBERS

Strengthening Food Security & Nutrition Resilience in Ethiopia

A Collaborative UNICEF-WFP-FAO Initiative

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Strengthening Food Security & Nutrition Resilience in Ethiopia

A Collaborative UNICEF-WFP-FAO Initiative

Context

Ethiopia has experienced unprecedented economic growth in recent years backed by a strong government commitment to support agricultural led development. However, the acute food and nutrition crisis of 2011-2012 is a stark reminder of the depth of vulnerability that still exists. Ethiopia’s swift response to the crisis, using new contingency instruments including risk financing and the Productive Safety Net Programme (PSNP) were able to mitigate the worst outcomes. But significant work remains to be done in order to strengthen the architecture to harmonize humanitarian and development interventions, and to improve food and nutrition security outcomes. Resilience is a growing global and regional concern, especially in the face of climate change and its escalating impact. Internationally, the Disaster Risk Reduction agenda, as articulated in the Hyogo Framework, identifies climate change as a priority global risk. In response, new instruments such as the Global Climate Change Alliance have established action-based funding mechanisms. Regionally, IGAD’s Drought Disaster Resilience and Sustainability Initiative (IDDRSI) seek to end drought emergencies in the Horn of Africa and drive economic growth. IDDRSI comprises both regional and national programming papers and associated investment programmes. Informed by IDDRSI, the Ethiopia Humanitarian Country Team (EHCT) recently adopted a Towards Resilience - Position Paper for EHCT to inform and influence the resilience policy dialogue between EHCT members and the Government. Centrally involved in the developed of EHCT’s Resilience Paper, FAO, WFP and UNICEF are well placed to promote and support resilience mainstreaming at policy and programming levels. At the policy level, the three agencies have been actively involved in the development of the IDDRSI Country Programme Paper, in the review and strengthening of the National Nutrition Programme, and in the National DRM Policy and the associated Strategic Investment Programme (SPIF). At the programme level, the three agencies implement projects that at one level or another seek to build resilience. For example, WFP and FAO have initiated a partnership focusing on synergies of integrated watershed management activities to strengthen links between upper watershed management and on-farm agricultural production and productivity. WFP’s partnership within the R4 also presents sustainable efforts to build more resilient livelihoods protected through risk transfer mechanisms. The three agencies are also in partnership with other UN agencies including UNDP, UNCDF, WHO and UN-Women to implement the UN Joint Programme on Developing Regional States (DRS). The DRS’s development objective is to enhance public service delivery for accelerating development outcomes in Ethiopia’s four Developing Regional States. The two underpinning strategies for the Joint Programme are (a) building resilience against recurrent natural hazards and emergencies, and (b) promoting equity through development of under-served areas. Taken together, UNICEF, WFP and FAO operate at scale in Ethiopia. Yet, in the face of pervasive and enduring poverty and malnutrition, the three agencies recognise that much more must be done to address the needs of the current and future generations. This recognition triggered the joint initiative starting with the heads of agencies and leading to an agree focus on resilience-building and a specific focus on food and nutrition security as the agencies are each committed to improving

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nutritional outcomes.. The heads of agencies recognised that to address these problems that they would need to work together more effectively, reduce overlaps and add value to Government-led poverty and hunger reduction and increased resilience building policies, strategies and programmes.

The Challenge

Despite impressive economic growth, malnutrition and hunger still persist. From 2005-2012, Ethiopia sustained double digit economic growth rates. Despite this impressive progress, poverty remains unacceptably high with 80 per cent of rural Ethiopians continuing to live below the poverty line and more than 30 million Ethiopians living below the food poverty line.1 This is most dramatically evident in children; an estimated 44 per cent of children in Ethiopia are stunted with levels rising to over 55 per cent in Amhara Region.2

Hunger and malnutrition have a direct cost in lives damaged and economic potential lost. The recent Cost of Hunger Study estimates that the annual costs associated with child malnutrition alone are equivalent to 16.5% of GDP. With 2 out every 5 children stunted, the long term implications are even greater as this lost generation will be less productive, less able, and less well. In the effort to reach middle income status, Ethiopia is hampered by the fact that 67% of the adult population suffered from stunting as children. 3

There is growing consensus that building resilience to shocks and stresses saves money as well as lives. An analysis of the economics of resilience in Ethiopia found that early response is far more cost effective than late humanitarian response, and that investing in resilience is the best value for money. For example, a comparison of investments in Borena zone showed that the total investment required for emergency response and recovery could fund investment in resilience for 24 years consecutively.4 An analysis of Disaster Risk Reduction work in Malawi

found that for every dollar

invested net benefits of $24 were delivered to communities - helping them to overcome food insecurity while building their resilience to drought and erratic weather.5

East Haraghe provides a direct and immediate example of the need for new integrated approaches. Despite decades of concentrated humanitarian and development efforts, it remains stricken with unacceptable levels of under-nutrition. Figure 1 shows that year-on-year, there are consistent SAM seasonal admission trends pointing to the depth of vulnerability, the lack of resilience to shocks and stresses, and the need to do things differently.

1 MOFED (2010) Growth and Transformation Plan for Ethiopia 2 Government of the Federal Democratic Republic of Ethiopia (2013) National Nutrition Programme 3 WFP, ECA, African Union (2013) Cost of Hunger in Ethiopia: Implications for the Growth and Transformation of Ethiopia. Addis Ababa 4 Cabot-Venton et al (2012) The Economics of Early Response and Disaster Resilience: Lessons from Kenya and Ethiopia, DFID 5 Siedenburg et al (2011) Investing in Communities: a cost-benefit analysis of building resilience for food security in Malawi. ODI

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Structural vulnerabilities and challenges are exacerbated by disaster. More disasters are recorded in sub-Saharan region than in any other sub-region including the recent 2011 Horn of Africa drought that was described at the time as the largest food security crisis in the world. The connection between shocks such as drought, food and nutrition outcomes and longer term resilience is clear. In Ethiopia, children born during a drought are more likely to be chronically malnourished later in childhood than those who are not.6 In fact, it has been estimated that more than 20% of adult height variation in developing countries (the physical sign of having experienced chronic under-nutrition in childhood) is determined by environmental factors, in particular drought.7

Climate Change leads to weather variability and to extreme events and hazards. Ethiopia’s economic growth and the livelihoods of the people are already negatively impacted by current weather variability. FEWS NET reports a 20 per cent reduction in the belg rains in southern Ethiopia over the last 50 years. The belg rains have under-performed in 5 of the last 7 years resulting in higher levels of food and nutrition insecurity.8 These impacts could get worse with climate change according to the CRGE. By 2050, the negative impacts of climate change under an extreme scenario could cost Ethiopia 10% or more of its GDP – and have a huge impact in terms of lives and livelihoods lost.9

6 Fuentes, R. et al (2007) The Short-term and Long-term Human Development Effects of Climate related Shocks: some Empirical Evidence. New York. UNDP 7 Silventoinen, K (2003) Determinants of variation in adult body height. Journal of Biosocial Sciences 8 FEWS NET (2012) 9 Federal Democratic Republic of Ethiopia (2013) Ethiopia’s Climate Resilient Green Economy – Climate Resilience Strategy for Agriculture (draft)

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Admissions Collected Reports

Figure 1 – TFP SAM Admission Trends

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Resilience and the Link to Food and Nutrition Security

Resilience is a holistic concept. The Ethiopian Humanitarian Country Team defines resilience as the ability of countries, communities, and households to anticipate, adapt to, and recover from the effects of hazards (natural disasters, economic stability, conflict) in a way that protects livelihoods, accelerates and sustains recovery, and supports economic and social development. This means strong systems must be in place to deliver resilient outcomes, and to prevent and counter the effects of shocks and stress.

Resilience requires access to:

• Basic Social Services

• Predictable Safety Net Transfers

• Productive Livelihood Support

• Protection from Shocks

Figure 2

Food and nutrition security is a central building block of the resilience strategy adopted by the three agencies in Ethiopia. Building resilience is multi-faceted with food security and nutrition a key structural foundation. At its most fundamental core, there is no better single indicator of resilience than the level of child nutrition.10 Children who are under-nourished in their first 1,000 days are disadvantaged for life and are much more likely to be trapped in a cycle of poverty and under-nutrition. In essence, well-nourished people are more resilient to shocks and disaster than those who are not.

Food security and nutrition resilience can be defined as:

Ability to anticipate, adapt and recover from shocks without malnutrition spikes or damaging coping strategies

Strengthened systems that quickly respond to shocks by scaling-up food and nutrition responses

Sustainable resilience requires, among other interventions, addressing acute and chronic malnutrition together. Protecting nutrition outcomes from shocks involves managing under-nutrition in all forms. This means addressed both acute and chronic malnutrition to prevent the knock-on impact on growth and development across the nation.

10 Gubbels, P. (2011) Escaping the hunger cycle: pathways to resilience in the Sahel. Sahel Working Group/ Groundswell International.

Basic

Social

Services

Safety

Nets

Livelihood

Support

DRR / DRM

Strengthened Systems

Food &

Nutrition

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Our Response

We are already deeply engaged in activities that build resilience but we need to do more. WFP, UNICEF and FAO operate at scale. Together the three agencies implement some of the largest UN programmes globally; $1 billion11 in resources with over 1400 staff in every region of the country. This unprecedented scope and scale will be leveraged to focus on addressing and ultimately ending hunger and malnutrition in Ethiopia.

Building on the breadth and scale of current operations, we will increase the impact of our programmes by working together to improve food and nutrition outcomes. We will innovate to see what works best, prioritize learning and then adjust field programmes to achieve more. We will also bring this robust evidence base to broader government-lead policy and strategy processes to help mainstream the lessons in GoE flagship programmes. As part of this work, we will increase levels of technical assistance and support to PSNP and other GoE flagships as it is only through building robust and sustainable national systems that deliver on resilience that hunger and malnutrition can be ultimately addressed in Ethiopia. It is an urgent and unequivocal call to action.

Conceptual Framework

The strategy is based on a conceptual framework that the three agencies have developed (Figure 3). The framework emphasizes the synergistic relationship between joint programming, knowledge management and policy. A strong knowledge management function distils lessons from joint programming experience and feeds into the policy level. Engagement at the policy level in turn helps guide the areas of focus in both the knowledge and programming spheres. It is a responsive and synergistic model focused on helping to build strong national systems that will deliver resilience in the long term.

Figure 3

11 One of the driving reasons for this intervention is that a significant proportion of the agencies programme budget goes to humanitarian intervention, justifying the initiative on alternative long term solution to recurrent shocks.

Policy

Knowledge

FoodSecurity&Nutri onResilience

Program

• NNP• PSNP/HABP

• Social Protection• DRM SPIF

• CRGE

• Innovation• Best practice

• Action research• Systems building

Address both chronic and

acute under-nutrition

• Scale up CBN

• CMAM and TSF

• Integrated WASH

• Schools as a focal

point for services

• Nutrition-sensitive

agriculture

• Social protection – cash

transfers for most

needy

• Nutrition based DRM

Conceptual Framework

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To enable this new approach we will focus on both the community and systems level:

Community Level

Help facilitate and ensure:

1. Access to basic social services to build human capital

2. Access to appropriate productive sector/services/markets to build livelihoods and income

3. Access to predictable transfers to cover food gaps and encourage productive risk taking

4. Access to timely protection from shocks through effective and appropriate DRM response to protect development investments and safeguard food and nutrition outcomes

Systems Level

5. Strengthen local level systems to deliver resilience focusing on participatory planning and coordination (community, kebel, woreda)

6. Strengthen national level systems by engaging in key national processes with one voice to provide technical and strategic inputs to strengthen system development. Target PSNP/HABP/DRM design process, social protection platform, and CRGE.

By emphasizing innovation and real-time experiential learning, the knowledge gained through the implementation of an integrated joined-up approach will be fed directly into systems strengthening initiatives.

Approach

1. Galvanize and focus our efforts to end hunger and under-nutrition in Ethiopia

Ensure we address chronic and acute malnutrition together in an integrated approach; both stunting and wasting. Address long-term vulnerability trends and short-term hazards therefore addressing both long and short-term nutrition challenges.

Prioritize improved nutrition outcomes as a proxy for wider resilience. The focus is informed

by DFiD resilience analysis framework, outcomes and nutrition resilience concepts.

Recognize our efforts alone are not enough – we will be central to helping build and strengthen the systems needed to respond to shocks with strong links to long term resilience building.

2. Community Level: Increase food security and nutrition outcomes in our own programmes

Harmonize our own programmes and combine interventions to increase food security and nutrition outcomes. Deepen our collaborative efforts at all levels.

Harmonize approaches and methodologies for best practice and to reduce transaction costs at all levels starting with communities and local governments.

3. Systems Level: Increase food security and nutrition outcomes in major national processes

Use our experience and lessons learnt to inform strategic national processes

Actively learn, document, and synthesize lessons learned and feed into national processes such as PSNP by building a strong knowledge function that can quickly compile field level lessons.

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Harmonize agency inputs through establishing one joint voice to reduce transaction costs to these processes, and to ensure key concentrated information is brought forward.

Ensure consistency of engagement with adequate senior capacity to engage strategically with the flexibility to take on additional tasks as they emerge within the national processes.

Core programming components

Area intervention teams will be formed to undertake real-time analysis to plan harmonized interventions that are responsive to local needs. Specific interventions will be determined through enhanced community dialogue with a primary focus on addressing the specific causes of food insecurity and malnutrition. Field staff will be empowered with full management support to think nationally while engaging locally; that is, to determine what can be done locally to build resilience that can also inform the development of a national system. The core programming components are: 1. Community Based Nutrition (CBN)

Expand CBN activities to all PSNP operational areas and strengthen linkages with national processes starting with the PSNP/HABP. Prepare to expand to all PSNP expansion areas as the re-design process unfolds. Include urban areas in the roll-out process.

Integrate CMAM, TSF and prevention of acute malnutrition activities within CBN. Harmonize under REACH and SUN initiatives.

Increase salt iodization

Expand and integrate WASH activities in all PSNP operational areas??

Establish schools as a focal point for service delivery

For awareness creation

For WASH

For agriculture and livelihoods training

For local production through Home Grown School Feeding

For reaching children in times of stress

Ways of Working

Complementary not competitive: break down old ways of working by building a new collaborative paradigm with appropriate incentives

Adding value not duplicative: avoid creating separate institutional architecture or information systems; add value to existing processes instead

Flexible and responsive: each focus region will develop the most appropriate mix of programming adapted to regional specifics. The lessons from this increased collaboration will be systematically analyzed, synthesized and brought upwards to the national level to inform, guide and enrich national efforts.

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2. Nutrition Sensitive Agriculture with Livelihood Diversification

Embed nutrition sensitive agriculture and livestock activities within key processes beginning with the PSNP and SLMP flagships.

Promote Integrated Watershed Management ‘Plus’ that is linked to Livelihood Diversification and strongly linked to CBN. Promote alternative livelihood options that can be taken up by the PSNP/HABP s.

Promote specific agricultural activities identified within the NNP as key for strengthening food and nutrition outcomes.12

3. Social protection with a focus on cash transfers within the context of PSNP and the Social

Protection Policy

Broaden engagement with MOLSA and the Social Protection Platform to build strong linkages with the PSNP process focusing on the Direct Support Group

Ensure that food and nutrition is mainstreamed within the social protection roll-out

Strengthen the ability of MOLSA to fulfil its roles and obligations under the Social Protection Policy and in relation to the PSNP process

4. Food and Nutrition sensitive Disaster Risk Management

Embed nutrition concepts within DRM systems including EWS, risk financing triggers, and risk financing /humanitarian response. Ensure that the EWS and contingency planning system can capture and plan for the following information13:

increases in acute malnutrition and micronutrient deficiencies

deterioration in the diets of women, children and other vulnerable groups

disruption to care of infants, young children and women

increases in illness among women, children, and other vulnerable groups

5. Robust Knowledge Management

Develop a robust evidence base which includes analysis of which interventions and approaches are most effective. The identification, synthesis and sharing of technical innovations, and lessons learnt is a priority. Emphasis will be given to defining streamlined ways to identify and compile joint lessons and to package them for easy consumption for dissemination within the target national processes. Ensure internal capacity is adequate to generate credible information in a manner that is appropriate for decision makers at each level.

Provide Technical Assistance at national and regional levels to help generate the initial knowledge base while ensuring government ownership from the beginning.

Harmonize the 3 agencies’ information systems and ensure that they do not duplicate or displace GoE systems. The aim will be to avoid the temptation to build additional information architecture that is independent of government as this can lead to a delay in response, especially at the start of a crisis when such reports proliferate and can cause confusion. Local government will be central to the process in order to ensure ownership of the information products, and the proposed solutions.

12 See Annex 2 13 DFID IBID

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Emphasize rigorous M&E systems within the knowledge management component, but put greater emphasis on helping to build the local level M&E system with a view to using this experience to influence the direction of the national flagships/processes. Build on existing systems wherever possible rather than create new and potentially duplicative procedures. Build on existing data sets and baselines rather than recreate.

6. Strengthen Regional and Woreda government systems

Target woreda level government institutions for systems strengthening

Build on UNICEF’s experience of rationalizing the roles and responsibilities of the health sector front line service delivery system. Target front line service delivery institutions and workers. In particular, help rationalize the roles of HEWs, DAs, social workers and the Development Army in order to deliver better nutrition and food security outcomes

Focus on building the overall capacity of local government to plan and coordinate. Broaden the use of ICDDP as a methodology for planning as pioneered in Tigray and further developed by the DRS initiative. Under BoFED coordination, the aim is to help kebele councils design plans with the communities and to link those plans to the woreda level planning process.

Build capacity to undertake new integrated roles and responsibilities

Target regional and national government institutions for strategic technical assistance

Provide skilled senior level Technical Assistance based on a demand as generated by the major flagship processes. The comparative advantage of the 3 agencies is at regional level and below, but flexibility will be maintained to ensure that the placement of TAs is responsive to the priority emerging demands of the GoE.

Targeting Front Line Service Delivery Workers

UNICEF has successfully worked with the Ministry of Health to help rationalize, train, and build the capacity of the Health Extension Worker cadre (HEWs).

Through a participatory and responsive approach under GoE leadership, gaps in the system were identified, roles and responsibilities examined, and solutions tested with a close eye on available fiscal space.

Once field tested, the ensuing system was rolled out nation-wide with ongoing capacity support in place to ensure sustainability.

This model could provide a blueprint for rationalizing the roles and responsibilities of all front line workers including HEWs, DAs, Social Workers, and Development Army workers.

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Beneficiary Target Group

The primary focus for direct interventions will be on PSNP beneficiary households14 with particular emphasis on the most vulnerable including women and child-headed households (estimated to be 25 per cent of all households) in the selected operational areas.

Geographical Focus

The geographical focus will be on Level 1 ‘hotspots’ and PSNP operational woredas. However, many

of the activities such as the expansion of CBN will be woreda-wide, region-wide, and in many cases

nation-wide.

Common Results Framework

Develop a common results framework and ensure all other programming takes into account the strategy and framework. Build on existing national results frameworks as much as possible: the NNP, the Social Protection Policy and the emerging frameworks of the PSNP/ HABP/ DRM re-design and the CRGE processes. Build on existing data and baselines such as IFPRI in-depth woreda level monitoring.

Timeframe

The overall resilience strategy will remain in place for 10 years or more to underscore the importance of sustained and consistent engagement. The first programming cycle will be for 3 years and will be integrated under the existing UNDAF framework. The second programming cycle will broaden the agencies involved and the number of sectors such as education.

14 Initial thinking, to be reviewed further.

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Annex 1 - Agency Risks and Management Implications

Risks

The resilience strategy is perceived as a re-branding exercise rather than a meaningful shift in approach.

The DPs perceive the strategy as competing with PSNP for resources, that it distracts the Ministry on another agenda, and that it pulls resources out of PSNP at a time when it is underfunded.

Engagement within flagships such as the PSNP lacks continuity and senior level engagement, has fragmented messaging from the 3 agencies, does not bring technical expertise and lessons to the table, and is perceived as not adding value.

The process takes too long, is too complicated, too inward looking, too heavy a process, establishes additional architecture, and demands too many human resources

Opportunity cost: the risk that the bulk of effort goes into the internal layering of the 3 agency efforts including the establishment of unnecessary new architecture. Instead, the majority of this effort should be targeted for engagement in the external environment. For example, Somalia took 2 years to establish a baseline when they already had an established information system through the FSNAU.

Despite the policy, staff continue to compete for resources rather than complementary approaches

HQ and regional levels within each agency are not fully involved and put pressure on each agency to compete for resources. The Heads of Agency need to manage respective HQs with common messages to counter-act.

Management Implications and Action

The new strategy has a strong emphasis on collaboration, consultation, systems strengthening and other staff intensive processes. Engaging in the PSNP/HABP re-design alone will require a major commitment of senior staff time. This must be acknowledged and planned for up front as it will otherwise undermine the chances of success. This implies the need to:

Demonstrate strong and consistent Heads of Agency leadership from the start and back it up with clear performance targets and incentives; institutionalize the desired shift and do not leave it at the paper policy level

Agency Heads to actively cultivate champions at regional and HQ level.

Build internal entry points between agencies from simple, sensible points of engagement, rooted at field level with the aim to expand areas of collaboration as the relationship builds

Facilitate a shift in mind set.

Provide a series of incentives for staff to develop their own areas of engagement. Recognize possible areas of resistance including resource competition; from competition to collaboration.

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Dedicate senior staff to targeted processes from the outset – staff it right from the outset

3 person team nationally, regional teams, strong additional TA at regional levels.

Heads of agencies to budget HR; do not plan for implementation to take 120% of capacity; protect space for strategic engagement.

Build incentives (e.g. within performance plans) to ensure strategic engagement.

Ensure staff incentives encourage a shift from competing for resources to building complementary approaches. Aim to reward staff for demonstrating progress in joint programming.

Train staff in partnership/process skills to ensure strategic engagement; and to build trust.

Guard against individual agency promotion or promotion of individual projects; consistently monitor and work to intervene while rewarding those who follow the new approach.

Ensure that the 3 agencies request resources together at every opportunity.

Look for new resource envelopes such as CRGE.

Keep transaction costs low; Focus on system building rather than program building. Keep the process as administratively light as possible while recognizing that it will require serious HR investment with new HR resources.

Resist developing new M&E instruments and processes; maximize existing results frameworks, especially those agreed with government such as the NNP.

Engage at all 3 levels; local (community/kebel/woreda), regional and national. Each level is important and feed into each other. Focusing on just one level will not be sufficient.

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Annex 2 – National Nutrition Programme: Areas of Relevance

The National Nutrition Programme was updated in June 2013. It outlines nationally agreed strategic objectives linked to initiatives that should serve as the starting point for determining areas for complementary action in nutrition for the three agencies. The objectives are to:

Improve the nutritional status of women and adolescents

Improve the nutritional status of infants, young children, and children under 5

Improve the nutrition services for disease

Strengthen implementation of nutrition sensitive interventions across sectors

Improved multi-sectoral coordination and capacity to ensure NNP implementation

A number of sectors are of particular significance for the resilience strategy. The following areas require strengthened implementation of nutrition sensitive interventions that are most relevant to the comparative advantage of the 3 agencies:

Agriculture

MoA’s agriculture FS programme (4 components), and other programmes and systems (Ag Extension Programme, AGP, Ag Research) need to be scaled up to deal with under-nutrition with more emphasis on increasing the quality of food produced and mainstreaming nutrition. Relevant initiatives:

Increase production of fruits, vegetables, nutritious roots, cereals and pulses to diversify diet (FAO)

Improve access to and utilization of animal source foods (FAO)

Promote appropriate technologies for food production and processing (WFP and FAO)

Promote value addition (FAO)

Promote consumption of diversified foods (all)

Support local complementary food production (WFP and FAO)

Support agricultural research to develop seeds of high nutritional value (FAO)

Strengthen the capacity of the agriculture sector to integrate nutrition sensitive interventions including DAs (All)

Water sector / WASH

Increase access to safe water (provide water supply in urban, rural and pastoralist areas; water for sewage facilities) (UNICEF)

Increase irrigated farmland through IDP and sustainable water supplies for livestock production in pastoral areas (FAO and WFP through Watershed Management Plus)

Social protection services

Promote social safety nets and other social protection instruments (All)

Promote provision of microfinance services and IGA with focus on unemployed women (FAO and WFP)

Increase access to basic nutrition services for all vulnerable groups (UNICEF and WFP)

Strengthen and expand the Social Cash Transfer Programme (UNICEF and WFP)

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DRR: protecting households from shocks and vulnerabilities that affect their nutrition

Strengthen and scale up EWS for food and nutrition from community to national level (All)

Facilitate community participatory risk assessment and preparedness planning (WFP and All)

For emergencies/humanitarian, develop comprehensive package of nutrition services and build nutrition into emergency response in a more effective manner (UNICEF)

Multi-sectoral Coordination and Capacity: (All)

Improve capacity of Development Army to support nutrition

Improve capacity for nutrition M&E and operational research

Improve multi-sectoral coordination capacity at all levels – with a focus on regional and woreda levels for the 3 agencies

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Annex 3 - Programmes by Agency - Addressing Chronic and Acute Malnutrition and Hunger

Thematic Intervention Areas Stunting - Chronic Malnutrition

Chronic

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Thematic Intervention Areas Wasting - Acute Malnutrition

Acute